Study On Liver Tissue Pathological Characteristics Of "Different Syndromes Of The Same Disease" In Non-alcoholic Fatty Liver Disease

Objective:In this study,non-alcoholic fatty liver disease(NAFLD)was classified by TCM syndrome differentiation,and the characteristics of liver tissue lesions and related clinical indicators of different syndrome types(Different Syndromes of the Same Disease)in the same disease were observed.Provide objective basis for the treatment of NAFLD based on syndrome differentiation of Chinese medicine.Give full play to the advantage of traditional Chinese medicine to "treat the disease",understand the syndromes of hepatic tissue disease,and carry out therapeutic intervention as early as possible to prevent or delay its development into cirrhosis and liver cancer.Methods:From August 2017 to December 2019,118 cases of non-alcoholic fatty liver disease that met the enrollment criteria were treated in the Department of Infectious Diseases of Xiamen Traditional Chinese Medicine Hospital,and the diagnosis and classification of TCM were performed to collect clinical data of patients.Including gender,age,course of disease,physical examination,serological indicators,imaging indicators,liver histology indicators,establish a database,use SPSS 22.0 statistical software for statistics,and analyze the distribution characteristics of different indicators of each syndrome type,especially non-alcoholic Features of liver tissue lesions with the same disease and different syndromes.Multivariate ordered logistic regression was used to analyze the influencing factors of liver fibrosis stage S.Results:A total of 118 patients were collected in this study,of which the syndrome type distribution: 68 cases of liver stagnation and spleen deficiency syndrome(57.63%)> 32 cases of damp heat syndrome(27.12%)> 12 cases of damp turbid internal syndrome(10.17%)>phlegm There were 6 cases(5.08%)of stasis and stagnation syndrome,and no spleen and kidney deficiency syndromes were collected.(1)The age,BMI,GLU,and liver tissue fibrosis stage(S)of NAFLD patients have statistically significant differences between different TCM syndrome types(both P <0.05),and have the relevant index characteristics of "same disease but different syndrome".Among the four types collected,patients with phlegm and blood stasis syndrome are the oldest.Patients with wet syndromes had the highest BMI and the lowest GLU.The liver tissue fibrosis stages of patients with phlegm and blood stasis syndrome are all ?S2,and the liver tissue fibrosis stage of more than 50% of patients with other three syndrome types is S1.(2)Of the 118 patients with NAFLD,22 had hypertension,19 had type 2 diabetes,18 had metabolic syndrome,13 had hyperlipidemia,20 had hyperuricemia,and 70 were diagnosed with Alcoholic steatohepatitis(non-alcoholic steatohepatitis,NASH).The proportion of the four syndromes diagnosed as NASH was ?50%.(3)There are no statistically significant differences in indicators such as gender composition,course of disease,waist-to-hip ratio,blood pressure,CAP,LSM,B-ultra fatty liver prompt index,NAS score,and degree of liver steatosis F in patients with different TCMsyndromes.(4)Multi-category ordered logistic regression analysis was performed with NAFLD patients' liver tissue fibrosis(S)as the dependent variable,TCM syndrome type,gender,age,disease course,serological indicators,BMI,NAS score as independent variables.The results showed that CHOL and LDL were the influencing factors of the development of liver tissue fibrosis(S)in patients with NAFLD.Conclusion:1.Phlegm and blood stasis syndrome is the oldest in patients with NAFLD,and the BMI of patients with NAFLD is higher than other syndromes,and the GLU is lower than other syndromes;2.The liver tissue lesions of NAFLD patients with different syndrome types are significantly different,and the fibrosis stage of liver tissue with phlegm and blood stasis syndrome is heavier than other syndrome types.It is of certain significance to explore the characteristics of liver tissue lesions with the same disease and different syndromes of NAFLD3.CHOL and LDL are the influencing factors of liver tissue fibrosis(S)progressive change(S0-4)in NAFLD patients.